[Shoulder dystocia--a rare obstetrical complication].

Shoulder dystocia is an uncommon complication of delivery with a high neonatal morbidity rate. This review describes the use of the most important shoulder dystocia maneuvers and underlines the demand to perform a written description of all details of the management during delivery.

[Endothelial cell damage in pre-eclampsia].

It was the aim of this paper to report on new estimations from the literature suggesting that vessel endothelial cell injury may be a very pathologic process in preeclamptic women. These reports relate to structural vessel endothelial cell damages in and outside of the placenta bed and in other body sides. Furthermore there are indirect estimations that indicate elevated plasma fibronectin concentration before preeclamptic symptoms becomes apparent, the activation of the coagulation cascade by damaged endothelium, the known reduced prostacyclin synthesis, an increased mitogenic activity and the occurrence of anti-endothelial cell antibodies in preeclamptic women, an increased number of circulating desquamated vessel endothelial cells in peripheral blood in patients with preeclampsia and an increased cytotoxic activity of preeclamptic serum against umbilical vein endothelial cells.